The relationship between plasma estradiol and the increase in bone density in postmenopausal women after treatment with subcutaneous hormone implants

Studd, John; Savvas, M.; Waston, N; Garnett, T; Fogelman, Ignac; Cooper, Derek

doi:10.1016/0002-9378(90)90608-a

Cited by 57 publications

(29 citation statements)

References 17 publications

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“…With a different proportion of cortical and cancellous bone [27] the skeletal response to ERT is also not uniform at different sites. Thus the greater rise in BMD at the lumbar spine than in proximal femur in this study, as also shown by others after short-term follow-up [11,12,18,19,28] was due to the varying rate of bone remodeling.…”

Section: Discussionsupporting

confidence: 65%

“…The same dose of estradiol implant resulted in a wide range of serum estradiol levels, as shown earlier [18][19][20], indicating a variation in pharmacodymamics and possible cumulative effect after long-term use, which may explain differences in bone collagen changes between patients. Serum estradiol level has been shown to correlate with the changes and post-therapy levels of cortical bone collagen but not with those of cancellous bone collagen.…”

Section: Discussionmentioning

confidence: 90%

“…Serum estradiol levels increase with higher-dose ERT and the BMD changes are related to serum estradiol concentration [18,19,29]. BMD at the lumbar spine or proximal femur represents cortical bone more than cancellous bone [27], and thereby both BMD and cortical collagen content correlate with serum estradiol.…”

Section: Discussionmentioning

confidence: 98%

“…Older postmenopausal women on ERT have shown greater bone gain, which is related to their lower BMD before starting the therapy [11,18,19,29]. It has been suggested that the greater the effect of estrogen deprivation, the greater the capacity of estrogensensitive tissue in responding to reintroduction of estrogen [11].…”

Section: Discussionmentioning

confidence: 98%

“…Similarly, in postmenopausal women the rise in bone mineral density (BMD) with long-term ERT indirectly suggests an anabolic effect [16], as the magnitude and continuity of such a change cannot be explained simply by reduced bone turnover [17]. A higher dose of ERT via subcutaneous implant has shown an even greater increase in BMD in postmenopausal women [18]. Interestingly, with the higher circulatory level of estrogen there is a continued dose response and the rise is greatest in those with lowest BMD [19].…”

Section: Introductionmentioning

confidence: 96%

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Anabolic Effect of Long-term Estrogen Replacement on Bone Collagen in Elderly Postmenopausal Women with Osteoporosis

Khastgir

Studd

Holland

et al. 2001

Osteoporosis International

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Estrogen has been shown to stimulate osteoblasts in cell culture and increase bone formation in animal models. Such an anabolic effect of estrogen replacement therapy (ERT) would be beneficial to postmenopausal women with osteoporosis. Hence, we assessed the total collagen content and collagen crosslink maturity in iliac crest bone biopsy from 18 such women before and after 6 years of higher-dose ERT. These results were compared with the serum estradiol level and bone mineral density (BMD). Total collagen content of both cortical and cancellous bone increased, showing a median (95% CI) percent change of 6.7 (0.3-14.2) and 25.6 (13.5-33.8), respectively. Increase in collagen synthesis was supported by a rise in intermediate crosslinks in both cortical and cancellous bone, and mature crosslinks in cortical bone only. At the same time, BMD showed a substantial rise both at the lumbar spine and proximal femur with a median (95% CI) percent change of 28.6 (19.8-37.3) and 14.5 (8.4-20.7), respectively. Serum estradiol and BMD results correlated with cortical bone collagen levels. Our results suggest that long-term higher-dose ERT has a therapeutic role due to its anabolic effect on bone in postmenopausal women with osteoporosis.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

Anabolic Effect of Long-term Estrogen Replacement on Bone Collagen in Elderly Postmenopausal Women with Osteoporosis

Khastgir

Studd

Holland

et al. 2001

Osteoporosis International

View full text Add to dashboard Cite

show abstract

References

2009

Biophysical Bone Behavior

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Do estrogens improve bone mineral density in osteoporotic women over age 65?

Marx

Dailey

Cheney

et al. 1992

Journal of Bone and Mineral Research

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A retrospective analysis of our experience with estrogen and fluoride treatment in 91 patients with postmenopausal osteopenia followed for 6-47 months has been performed. Treatment included calcium (1000 mg/day) and either conjugated estrogens (0.625 mg/day) or sodium fluoride (50 mg/day), or both. All patients had at least two serial dual-photon spinal bone mineral density measurements performed 6 months or more apart. Estrogen treatment was associated with increased bone mineral density (5.3%/year), as was fluoride alone (7.5%/year). Estrogen and fluoride together were additive (9.6%/year). In women over age 65 the estrogen effect was just as great (6.9%/year) as in younger women. Estrogen benefit occurred predominantly in the first 18 months of treatment (7.0%/year), after which time changes in bone mineral density were similar to those in untreated controls, who showed stable bone mineral density. We conclude that aggressive estrogen and fluoride treatment tailored to the severity of the individual's postmenopausal osteopenia results in short-term improvement in spinal bone mineral density. These data further support that elderly women respond to estrogen replacement therapy with absolute and relative increments in bone density similar to those in younger women.

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The relationship between plasma estradiol and the increase in bone density in postmenopausal women after treatment with subcutaneous hormone implants

Cited by 57 publications

References 17 publications

Anabolic Effect of Long-term Estrogen Replacement on Bone Collagen in Elderly Postmenopausal Women with Osteoporosis

Anabolic Effect of Long-term Estrogen Replacement on Bone Collagen in Elderly Postmenopausal Women with Osteoporosis

References

Do estrogens improve bone mineral density in osteoporotic women over age 65?

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